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v12 radiosurgery

Byron Wilson, Karl Otto, Ermias Gete
INTRODUCTION: We present a Trajectory-based Volumetric Modulated Arc Therapy (TVMAT) technique for Stereotactic Radiosurgery (SRS) that takes advantage of a modern linacs ability to modulate dose rate and move the couch dynamically. In addition, we investigate the quality of the developed TVMAT method and the dosimetric accuracy of the technique. METHODS: The main feature of the TVMAT technique is a standard beam trajectory formed by dynamic motion of the treatment couch and the linac gantry...
January 2017: Medical Physics
T Lamberton, J Slater, A Wroe
PURPOSE: Stereotactic radiosurgery is an effective and noninvasive treatment for intracranial lesions that uses highly focused radiation beams in a single treatment fraction. The purpose of this study is to investigate the dosimetric differences between the treatment brain metastasis with a proton beam vs. intensity modulated radiation therapy (IMRT). METHODS: Ten separate brain metastasis targets where chosen and treatment plans were created for each, using three different strategies: custom proton beam shaping devices, standardized proton beam shaping devices, and IMRT...
June 2016: Medical Physics
J Maurer, B Sintay, M Manning, D Wiant, H Liu
PURPOSE: This study evaluates a novel algorithm that can be used with any treatment planning system for simple and rapid generation of stereotactic radiosurgery (SRS) plans for treating multiple brain metastases using a single isocenter dynamic conformal arc (DCA) approach. This technique is compared with a single isocenter volumetric modulated arc therapy (VMAT) technique in terms of delivery time, conformity, low dose spread and delivery accuracy. METHODS: Five patients, with a total of 37 (5 - 11) targets were planned using a previously published method for generating optimal VMAT plans and using the proposed DCA algorithm...
June 2016: Medical Physics
Y Chen, C Li, C Yang
PURPOSE: Safe treatment of the maximum tolerable brain metastases with GK in single patient-clinical findings METHODS: A patient diagnosed with stage IV NSCLC has received 6 courses of Gamma Knife radiosurgery (GKRS) treatments. The plans were generated with GammaPlan (version 10.1.1), six courses of treatment were administered in 2.5 years. A total of 53 metastases were treated with retreatment foci (n = 5) and planned on newly identified lesions (n = 48). Individual prescription dose varied from 12 Gy to 24 Gy...
June 2016: Medical Physics
C Yeboah, M Ruschin, Y Lee, A Sarfehnia, B Chugh, S Myrehaug, M Tsao, H Soliman, A Sahgal
PURPOSE: To assess the feasibility of designing clinically-acceptable stereotactic radiosurgery (SRS) plans utilizing linac-based cone collimators for patients presenting with acoustic neuroma. METHODS: Five acoustic neuroma patients with gross tumour volumes (GTVs) of sizes from 1.3 to 2.7 cc were studied. The cranial-caudal extent of the GTVs range from 1.1 to 1.7 cm whereas the largest cross-sectional extent of the lesions varied from 2.0 to 2.4 cm. No PTV margin was added...
June 2016: Medical Physics
J Baker, J Gibb, S Ailawadi, A Hsia, J Han, J Kim, Z Xu, S Ryu
PURPOSE: The volume of normal brain tissue exposed to doses above 12 Gy (V12) strongly predicts the risk of radionecrosis. A negative margin MLC aperture results in fields smaller than the PTV. The aim of this study is to investigate the relationship between V12 and the negative margin MLC while keeping adequate PTV coverage with proper dose normalization. METHODS: Spherical PTVs were contoured with a center of mass in the frontal and left temporal lobe ranging in size from 1 cm to 4 cm in diameter...
June 2016: Medical Physics
D Levin, E Shekel, D Epstein, R Spiegelmann, R Pfeffer
PURPOSE: To evaluate a new, automated brain metastases planning software designed to treat up to ten brain metastases simultaneously. METHODS: We treated 61 patients with multiple brain metastases using the Elements software by BrainLab (Munich, Germany). Patients had between 2-10 metastases ranging from 0.01-8.64 cc. Dose prescription was 18-24 Gy. Plans use up to 5 non-coplanar arcs with a single isocenter at the metastases' center of mass. The high degree of automation shortens the planning time to 15-20 minutes per patient...
June 2016: Medical Physics
Ganesh Narayanasamy, Sotirios Stathakis, Alonso N Gutierrez, Evangelos Pappas, Richard Crownover, John R Floyd, Niko Papanikolaou
BACKGROUND: In this treatment planning study, we compare the plan quality and delivery parameters for the treatment of multiple brain metastases using 2 monoisocentric techniques: the Multiple Metastases Element from Brainlab and the RapidArc volumetric-modulated arc therapy from Varian Medical Systems. METHODS: Eight patients who were treated in our institution for multiple metastases (3-7 lesions) were replanned with Multiple Metastases Element using noncoplanar dynamic conformal arcs...
September 9, 2016: Technology in Cancer Research & Treatment
Juan F Calvo-Ortega, David Delgado, Sandra Moragues, Miquel Pozo, Joan Casals
AIMS: To dosimetrically compare the fixed gantry intensity modulated radiosurgery (IMRS) with dynamic conformal arc radiosurgery (DCARS) for cranial lesions. This study investigates whether IMRS can be an adequate dosimetric alternative to DCARS for cranial stereotactic radiosurgery (SRS). SUBJECTS AND METHODS: Forty-five SRS procedures for solitary brain metastasis (range: 0.44-29.18 cm 3) performed at our institution were selected for this study. Two plans were generated per patient: One IMRS plan using a multileaf collimation (MLC) of 5 mm, and one DCARS plan designed with a 3 mm micro-MLC...
April 2016: Journal of Cancer Research and Therapeutics
Rafael Garcia, Kita Sallabanda, Iciar Santa-Olalla, Jose Luis Lopez Guerra, Lijia Avilés, Morena Sallabanda, Eleonor Rivin, José Samblás
Modern technologies allow the delivery of high radiation doses to intramedullary spinal cord metastases while lowering the dose to the neighboring organs at risk. Whether this dosimetric advantage translates into clinical benefit is not well known. This study evaluates the acute and late toxicity outcomes in a patient treated with robotic radiosurgery for an intramedullary spinal cord metastasis. A 50-year-old woman diagnosed in May 2006 with invasive ductal carcinoma of the right breast T2N3M1 (two liver metastases) received chemotherapy with a complete response...
2016: Curēus
Thierry Gevaert, Femke Steenbeke, Luca Pellegri, Benedikt Engels, Nicolas Christian, Marie-Thérèse Hoornaert, Dirk Verellen, Carine Mitine, Mark De Ridder
PURPOSE: To investigate the feasibility of a novel dedicated treatment planning solution, to automatically target multiple brain metastases with a single isocenter and multiple inversely-optimized dynamic conformal arcs (DCA), and to benchmark it against the well-established multiple isocenter DCA (MIDCA) and volumetric modulated arc therapy (VMAT) approaches. MATERIAL AND METHODS: Ten previously treated patients were randomly selected, each representing a variable number of lesions ranging between 1 to 8...
February 2, 2016: Radiation Oncology
Tianfang Li, Cihat Ozhasoglu, Steven Burton, John Flickinger, Dwight E Heron, M Saiful Huq
For targets with substantial volume, collimators of relatively large size are usually selected to minimize the treatment time in robotic radiosurgery. Their large penumbrae may adversely affect the dose gradient around the target. In this study, we implement and evaluate an inner-shell planning method to increase the dose gradient and reduce dose to normal tissues. Ten patients previously treated with CyberKnife M6 system were randomly selected with the only criterion being that PTV be larger than 2 cm(3). A new plan was generated for each patient in which the PTV was split into two regions: a 5 mm inner shell and a core, and a 7...
November 8, 2015: Journal of Applied Clinical Medical Physics
Andrew Woerner, John C Roeske, Matthew M Harkenrider, John Fan, Bulent Aydogan, Matthew Koshy, Robert Laureckas, Faisal Vali, Maria Campana, Murat Surucu
PURPOSE: A multi-institutional planning study was performed to evaluate the frequency that current guidelines established by Radiation Therapy Oncology Group (RTOG) protocols and other literature for lung stereotactic body radiotherapy (SBRT) treatments are followed. METHODS: A total of 300 patients receiving lung SBRT treatments in four different institutions were retrospectively reviewed. The treatments were delivered using Linac based SBRT (160 patients) or image guided robotic radiosurgery (140)...
August 2015: Medical Physics
Juan Francisco Calvo-Ortega, Sandra Moragues, Miquel Pozo, David Delgado, Joan Casals
To evaluate the dosimetric effect of placing the isocenter away from the planning target volume (PTV) on intensity-modulated radiosurgery (IMRS) plans to treat brain lesions. A total of 15 patients who received cranial IMRS at our institution were randomly selected. Each patient was treated with an IMRS plan designed with the isocenter located at the target center (plan A). A second off-target isocenter plan (plan B) was generated for each case. In all the plans,100% of the prescription dose covered 99% of the target volume...
2015: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Evan M Thomas, Richard A Popple, Xingen Wu, Grant M Clark, James M Markert, Barton L Guthrie, Yu Yuan, Michael C Dobelbower, Sharon A Spencer, John B Fiveash
BACKGROUND: Volumetric modulated arc therapy (VMAT) has been shown to be feasible for radiosurgical treatment of multiple cranial lesions with a single isocenter. OBJECTIVE: To investigate whether equivalent radiosurgical plan quality and reduced delivery time could be achieved in VMAT for patients with multiple intracranial targets previously treated with Gamma Knife (GK) radiosurgery. METHODS: We identified 28 GK treatments of multiple metastases...
October 2014: Neurosurgery
Jan Hrbacek, Stephanie Lang, Shaun N Graydon, Stephan Klöck, Oliver Riesterer
PURPOSE: To compare contribution and accuracy of delivery for two flattening filter free (FFF) beams of the nominal energy 6 and 10 MV and a 6 MV flattened beam for early stage lung cancer. METHODS: For each of 11 patients with stage I nonsmall cell lung cancer three volumetric modulated arc therapy plans were prepared utilizing a 6 MV flattened photon beam (X6FF) and two nonflattened beams of nominal energy 6 and 10 MV (X6FFF, X10FFF). Optimization constraints were set to produce dose distributions that meet the criteria of the RTOG-0915 protocol...
March 2014: Medical Physics
Terence T Sio, Sunyoung Jang, Sung-Woo Lee, Bruce Curran, Anil P Pyakuryal, Edward S Sternick
The authors compared the relative dosimetric merits of Gamma Knife (GK) and CyberKnife (CK) in 15 patients with 26 brain metastases. All patients were initially treated with the Leksell GK 4C. The same patients were used to generate comparative CK treatment plans. The tissue volume receiving more than 12 Gy (V12), the difference between V12 and tumor volume (V12net), homogeneity index (HI), and gradient indices (GI25, GI50) were calculated. Peripheral dose falloff and three conformity indices were compared...
2014: Journal of Applied Clinical Medical Physics
Karina P Esparza-Moreno, Olivia A García-Garduño, Paola Ballesteros-Zebadúa, José M Lárraga-Gutiérrez, Sergio Moreno-Jiménez, Miguel A Celis-Lopez
Trigeminal neuralgia (TN) is a chronic, episodic facial pain syndrome that can be extremely intense, and it occurs within the regions of the face that are innervated by the three branches of the trigeminal nerve. Stereotactic radiosurgery (SRS) is the least invasive procedure to treat TN. SRS uses narrow photon beams that require high spatial resolution techniques for their measurement. The use of radiographic or radiochromic films for small-field dosimetry is advantageous because high spatial resolution and two-dimensional dose measurements can be performed...
2013: Journal of Applied Clinical Medical Physics
Chuxiong Ding, Timothy D Solberg, Brian Hrycushko, Paul Medin, Louis Whitworth, Robert D Timmerman
PURPOSE: To investigate a multi-staged robotic stereotactic radiosurgery (SRS) delivery technique for the treatment of large cerebral arteriovenous malformations (AVMs). The treatment planning process and strategies to optimize both individual and composite dosimetry are discussed. METHODS: Eleven patients with large (30.7 ± 19.2 cm(3)) AVMs were selected for this study. A fiducial system was designed for fusion of targets between planar angiograms and simulation CT scans...
December 2013: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
I A Cetin, R Ates, J Dhaens, G Storme
BACKGROUND AND PURPOSE: The aim of the study was to validate the use of linac-based radiosurgery in arteriovenous malformation (AVM) patients and to predict complications using an integrated logistic formula (ILF) in comparison with clinical outcomes. PATIENTS AND METHODS: The results of radiosurgery in 92 AVM patients were examined. All patients were treated with linac-based radiosurgery. Of these, 70 patients were followed for 12-45 months (median, 24 months) and were analyzed...
December 2012: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
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